Diagnostic Value of Colposcopy and Cervical Biopsy in Cervical Intraepithelial Neoplasia

2021 ◽  
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
Diagnostic Value ◽  
Cervical Biopsy

scholarly journals Variability of Pathologists' Utilization of p16 and Ki-67 Immunostaining in the Diagnosis of Cervical Biopsies in Routine Pathology Practice and Its Impact on the Frequencies of Cervical Intraepithelial Neoplasia Diagnoses and Cytohistologic Correlations

2014 ◽  
Vol 138 (1) ◽  
pp. 76-87 ◽  
Author(s):  
Charanjeet Singh ◽  
J. Carlos Manivel ◽  
Alexander M. Truskinovsky ◽  
Kay Savik ◽  
Samy Amirouche ◽  
...  
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
Lower Range ◽  
Ki 67 ◽  
Detection Rates ◽  
Cervical Biopsy ◽  
Biopsy Specimens ◽  
Frequency Of Use ◽  
Lower Variability ◽  
The Impact

Context.—The use of p16 in cervical biopsies improves the accuracy of cervical intraepithelial neoplasia (CIN) diagnosis and grading and decreases its interpathologist variability. Objective.—To determine the impact of the frequency of use of p16 immunostains in cervical biopsies on pathologists' diagnoses of CIN grade 1 and grade 2 or above (CIN1 and CIN2+) and on cytohistologic correlations. Design.—We identified all cervical biopsy specimens with cytologic correlations subjected or not to p16 staining from January 1, 2005, to September 30, 2010; calculated each pathologist's percentage of p16 use; and correlated it with their major cytohistologic discrepancy rates, CIN2+ diagnoses, and CIN1/CIN2+ ratios. Results.—During the study period, each of the 23 pathologists interpreted 59 to 1811 (mean, 518) of 11 850 cervical biopsy specimens, used p16 for 0% to 21.31% (mean, 10.14%) of these, had CIN2+ detection rates of 9.5% to 24.1% (mean, 18.9%), and CIN1/CIN2+ ratios of 0.7 to 4.5 (mean, 1.5). Compared to the 12 “low users” of p16, who used p16 fewer times than the institution's mean for p16 use, the 11 “high users” of p16 diagnosed more biopsies (8391 versus 3459), had a lower rate of major cytohistologic discrepancies (12.62% versus 14.92%, P < .001), a higher rate of CIN2+ diagnoses (19.9% versus 16.4%, P < .001), a lower range of CIN2+ rates (15.0%–23.1% versus 9.5%–24.1%), and lower CIN1/CIN2+ ratios (1.2 versus 2.3). Conclusions.—We found a high intrainstitutional variability of p16 use in cervical biopsies, CIN2+ rates, and CIN1/CIN2+ ratios. Use of p16 for greater than 10% of cervical biopsies was associated with improved cytohistologic correlation rates and with lower variability in the frequencies of histologic diagnoses.

scholarly journals Role of p16/INK4a and Ki-67 as specific biomarkers for cervical intraepithelial neoplasia: An institutional study

2017 ◽  
Vol 9 (02) ◽  
pp. 104-110 ◽  
Author(s):  
Ankitha Hebbar ◽  
Venkataramappa Srinivasa Murthy
Keyword(s):  
Diagnostic Accuracy ◽  
Cervical Intraepithelial Neoplasia ◽  
Squamous Metaplasia ◽  
Intraepithelial Neoplasia ◽  
P Value ◽  
Kappa Statistics ◽  
Histopathological Diagnosis ◽  
Ki 67 ◽  
Cervical Biopsy ◽  
P16 Ink4a

Abstract BACKGROUND: P16/INK4a and Ki-67 have emerged as important biomarkers for the detection of high-risk human papilloma virus (HR-HPV) associated dysplastic changes in the cervical biopsy samples. The increasing inter- and intra-observer variability in the diagnosis of dysplastic lesions and immature squamous metaplasia on histopathology has led to the advent of these biomarkers. This study was taken up with an aim to study their role in increasing the diagnostic accuracy in equivocal cases on histopathology. MATERIALS AND METHODS: Fifty cervical biopsy specimens were stained with p16/INK4a and Ki-67 consisting of 10 cases each of cervical intraepithelial neoplasia (CIN I/II/III) along with five cases of squamous metaplasia. Histopathological diagnosis was considered as the gold standard. Statistical analysis was done by kappa statistics, and P value was calculated. RESULTS: The sensitivity and specificity of p16/INK4a and Ki-67 were 76.2%, 87.5%, 90.5%, and 87.5%, respectively. The overall agreement of both the immunostains with histopathological diagnosis was statistically significant (P < 0.05) and the diagnostic accuracy improved when both the stains were used in conjunction. CONCLUSION: Ki-67 and p16/INK4a can be used as complimentary tests in differentiating dysplastic and nondysplastic lesions and help in confirming the histopathological diagnosis. They aid in recognition of dysplasias caused by HR-HPV, which have higher tendency to progress to neoplasia. However, further research is advocated before the widespread use of these markers for screening of dysplasias.

Significance of Persistent Inflammatory Cervical Smears in Sexually Active Women of Reproductive Age Group—A Prospective Study

2010 ◽  
Vol 2 (1) ◽  
pp. 45-48
Author(s):  
Nidhi Gupta
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Histopathological Examination ◽  
Intraepithelial Neoplasia ◽  
Reproductive Age ◽  
Sexually Active ◽  
Women Of Reproductive Age ◽  
Medical College ◽  
Cervical Smears ◽  
Cervical Biopsy ◽  
Inflammatory Changes

ABSTRACT To study the significance of persistent inflammatory cervical Papanicolaou smears, in sexually active women of reproductive age group attending the out patient department of department of obstetrics and gynecology, Sarojini Naidu Medical College and Hospitals, Agra were recruited. Patients with persistent inflammatory cervical smears were subjected to Schiller directed cervical biopsy for histopathological examination. Persistent inflammatory changes were seen in 37.6% cervical smears. Underlying cervical intraepithelial neoplasia (CIN) on histopathologic examination was found in 13.6% persisters. Prevalence of CIN was higher in women over 30 years and significantly so in women with parity higher than 2. It was further observed that severity of underlying CIN lesions increased with increasing duration of marital life. Objective To study the significance of persistent inflammatory cervical smears in sexually active women of reproductive age. Study design A prospective tertiary teaching hospital based study on 3000 sexually active women aged between 18 to 45 years attending the OPD from October 2006 to December 2008. Material and methods Sexually active women aged between 18 to 45 years with inflammatory smears attending the OPD of the department of obstetrics and gynecology, SN Medical College and Hospital were recruited for the study. Repeat cervical smears were taken after 3 months of systemic antimicrobials plus local antiseptics. Patients with persistent inflammatory cervical smears were subjected to Schiller directed cervical biopsy for histopathological examination. Relationship of age, parity, duration of marital life, different contraceptive practices and other high-risk factors were studied vis-ì-vis histopathological findings of cervical intraepithelial neoplasia. Results Persistent inflammatory changes were noted in 37.6% cervical smears. Underlying cervical intraepithelial neoplasia (CIN) on histopathalogic examination was seen in 13.6% persisters. Prevalence of CIN was higher in women over 30 years, and over para 3 uninfluenced by the presence of cervical lesion. Severity of underlying CIN lesions increased with increasing duration of marital life. Conclusion Women with persistent inflammatory cervical smears, especially if she is above 30 years, sexually active for 10 years and is third para, should have further evaluation with cervical biopsy.

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